Clinical and microbiological features of Clostridium difficile infections in France: The ICD-RAISIN 2009 national survey

The surveillance of Clostridium difficile infections (CDI) in France was reinforced after the emergence of the PCR-ribotype 027 epidemic clone in 2006; notification of case clusters or severe cases by healthcare facilities (HCF) became mandatory. The French Public Health Surveillance Institute (InVS...

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Bibliographic Details
Published in:Médecine et maladies infectieuses 2013-02, Vol.43 (2), p.67-74
Main Authors: Eckert, C., Coignard, B., Hebert, M., Tarnaud, C., Tessier, C., Lemire, A., Burghoffer, B., Noel, D., Barbut, F.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Bacterial diseases
Bacterial diseases of the digestive system and abdomen
Bacterial Toxins - genetics
Biological and medical sciences
Clostridium difficile
Clostridium difficile - genetics
Clostridium Infections - drug therapy
Clostridium Infections - epidemiology
Clostridium Infections - microbiology
Clostridium Infections - prevention & control
Drug Resistance, Microbial
France
France - epidemiology
Gastroenterology. Liver. Pancreas. Abdomen
Health Facilities - statistics & numerical data
Health Surveys
Human bacterial diseases
Humans
Incidence
Infectious diseases
Long-Term Care - statistics & numerical data
Medical sciences
Microbial Sensitivity Tests
Other diseases. Semiology
Patient Admission - statistics & numerical data
PCR-ribotypes
Population Surveillance
Ribotyping
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Summary:The surveillance of Clostridium difficile infections (CDI) in France was reinforced after the emergence of the PCR-ribotype 027 epidemic clone in 2006; notification of case clusters or severe cases by healthcare facilities (HCF) became mandatory. The French Public Health Surveillance Institute (InVS) and the C. difficile National Reference Center (NRC) launched a national, prospective, multicentric survey to complete available data, in 2009. The survey had for objectives to assess CDI incidence and to characterize the strains responsible for CDI. Every month from March to August 2009, HCF notified the total number of new CDI cases, admissions, and patient-days (PD) to the InVS. A subset of participating HCF sent strains, isolated in March 2009 from CDI patients, to the NRC. One hundred and five HCF with acute care wards and 95 with rehabilitation/long-term care (RLTC) wards participated in the 6-month epidemiological study. The incidence of CDI was 2.28 or 1.15 cases per 10,000 PD in acute care (n=1316 cases) or RLTC (n=295 cases), respectively. Seventy-eight HCF participated in the microbiological study. Two hundred and twenty-four (94.9%) of the 236 strains received by the NRC were toxigenic. The five major PCR-ribotypes were 014/020/077 (18.7%), 078/126 (12.1%), 015 (8.5%), 002 (8%), and 005 (4.9%). The incidence of CDI in 2009 in France remained lower than in other European countries, suggesting a successful impact of the 2006 recommendations for CDI control. Suite à l’émergence du clone épidémique de PCR-ribotype 027 en 2006, la surveillance des infections àClostridium difficile (ICD) en France a été renforcée par le signalement des cas groupés ou sévères dans les établissements de santé (ES). En complément, l’Institut de veille sanitaire (InVS) et le laboratoire C. difficile associé au CNR des anaérobies ont réalisé en 2009 une étude nationale prospective multicentrique afin d’évaluer l’incidence des ICD et les caractéristiques des souches responsables d’ICD. De mars à août 2009, les ES déclaraient chaque mois à l’InVS le nombre total de nouveaux cas d’ICD, le nombre d’admissions et de journées d’hospitalisation (JH). Parmi ces ES, certains ont transmis au CNR les souches isolées en mars de patients infectés. Cent-cinq ES de court-séjour (CS) et 95 ES de moyen-long séjour (MLS) ont transmis des données épidémiologiques sur six mois. L’incidence globale des ICD en CS (1316 cas rapportés) était de 2,28 pour 10 000 JH. En MLS (295 cas rapportés), l’inci
ISSN:0399-077X
1769-6690
DOI:10.1016/j.medmal.2013.01.004